Related Experiment Video
Updated: Jan 10, 2026
13:35
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
4.0K
Breast surgery for metastatic breast cancer
Giuliano Tosello1, Rachel Riera2,3, Maria Regina Torloni4
1Instituto do Câncer Oeste Paulista (InCOP) and Universidade do Oeste Paulista (Unoeste), Presidente Prudente - São Paulo, Brazil.
The Cochrane Database of Systematic Reviews
|November 20, 2025
Summary
For metastatic breast cancer, surgery improves local control but not overall survival. Exploratory analysis suggests survival benefits for luminal tumors, but not HER2-positive or triple-negative types.
Area of Science:
- Oncology
- Surgical Oncology
- Clinical Trials
Background:
- Metastatic breast cancer (MBC) is incurable, yet survival is improving.
- Retrospective studies suggest breast surgery may improve survival in MBC, but are limited by selection bias.
- A systematic review of randomized controlled trials (RCTs) is needed to evaluate surgical benefits and harms.
Purpose of the Study:
- To assess the benefits and harms of breast surgery in women with metastatic breast cancer.
- To evaluate the impact of breast surgery on overall survival, quality of life, and disease progression.
Main Methods:
- Systematic review and meta-analysis of RCTs comparing breast surgery plus systemic therapy versus systemic therapy alone.
- Searches conducted across multiple databases (Cochrane, PubMed, Embase, etc.) up to April 2023.
- Primary outcomes: overall survival and quality of life. Secondary outcomes: progression-free survival and toxicity.
Main Results:
- Five RCTs (1368 women) included. Breast surgery improved local disease control (HR 0.43, high-certainty evidence).
- No significant improvement in overall survival (HR 0.89, moderate-certainty evidence).
- Exploratory analyses suggest potential survival benefit for luminal tumors, but not HER2-positive or triple-negative breast cancer. Quality of life and distant progression-free survival showed no significant improvement.
Conclusions:
- Breast surgery improves local disease control in de novo metastatic breast cancer but does not improve overall survival.
- Potential survival benefits in specific subgroups (e.g., luminal tumors) require further investigation.
- Surgery's impact on quality of life, distant progression, and toxicity appears minimal.
